Anesthesia with sevoflurane or isoflurane induces severe hypoglycemia in neonatal mice

PLoS One. 2020 Apr 2;15(4):e0231090. doi: 10.1371/journal.pone.0231090. eCollection 2020.

Abstract

Sevoflurane and isoflurane are among the most commonly used general anesthetics for children including infants, but their impact on metabolism, especially on blood glucose level, in children is not well understood. We investigated the impacts of anesthesia of neonatal (7-8 days old) and adult (2-3 months old) mice with the inhalational anesthetics 2.5% sevoflurane or 1.5% isoflurane, or the injectable anesthetics propofol (150 mg/kg) or avertin (375 mg/kg), for up to 6 hours. We found that sevoflurane and isoflurane induced severe hypoglycemia in neonatal mice and that this phenomenon was specific to the inhalational anesthetics because the injectable anesthetics propofol and avertin did not induce hypoglycemia. Surprisingly, the inhalational anesthesia induced hyperglycemia instead in adult mice. We also demonstrated that the inhalational anesthesia-induced hypoglycemia was a major cause of death for the neonatal mice receiving intranasal administration of saline prior to anesthesia. These studies revealed severe hypoglycemia in neonatal mice during anesthesia with sevoflurane or isoflurane. If this phenomenon also occurs in human, our findings would warrant closely monitoring blood glucose level and maintaining it in the normal range in infants receiving inhalational anesthesia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anesthesia Recovery Period
  • Anesthesia, Inhalation
  • Anesthetics, Inhalation / adverse effects
  • Anesthetics, Intravenous / adverse effects
  • Animals
  • Animals, Newborn
  • Blood Glucose / metabolism
  • Ethanol / analogs & derivatives
  • Ethanol / pharmacology
  • Hypoglycemia / blood
  • Hypoglycemia / chemically induced*
  • Insulin / blood
  • Isoflurane / adverse effects*
  • Mice, Inbred C57BL
  • Propofol / pharmacology
  • Sevoflurane / adverse effects*

Substances

  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Blood Glucose
  • Insulin
  • tribromoethanol
  • Sevoflurane
  • Ethanol
  • Isoflurane
  • Propofol

Grants and funding

This work was supported by the New York State Office for People with Developmental Disabilities, Albany, NY. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.